Oxford researcher awarded nearly £1m to explore potentially ‘game-changing’ treatments for prostate cancer

A Cancer Research UK Oxford Centre Member has been awarded almost £1m from Cancer Research UK to investigate a new form of treatment for prostate cancer.

Dr Richard Bryant, a consultant urologist and surgeon who treats patients from across Oxfordshire, will use the cash injection to investigate combining a new form of treatment alongside conventional radiotherapy for men with advanced or aggressive forms of prostate cancer.

If his research proves to be both safe and effective for patients, Dr Bryant believes it could be “game-changing” for men diagnosed with the disease in the future.

Dr Bryant, a consultant urological surgeon at the University of Oxford’s Nuffield Department of Surgical Sciences, was awarded a Clinician Scientist Fellowship, which supports cancer doctors carrying out research. He will receive £847,242 over five years to carry out his research in the hope of transforming treatments for future prostate cancer patients.

His project will look at the use of vascular-targeted photodynamic therapy (VTP) – a novel form of minimally invasive surgery that uses light treatment to target the destruction of a specific area of tissue such as a tumour while limiting any potential damage to healthy tissue – in combination with radiotherapy. The aim is to establish if the combined VTP and radiotherapy treatment is more effective that each treatment given alone.

Prostate cancer is the commonest cancer in men in the United Kingdom and around 500 men are diagnosed in Oxfordshire every year.

Many patients currently receive a course of radiotherapy, which is delivered over approximately six weeks. Many of these patients will be cured by radiotherapy, but in some patients the cancer can return, and in addition to this the radiotherapy itself can have significant side effects.

The new form of light treatment, or VTP, damages the blood vessels and ‘starves tumours’ thereby destroying them. It has recently been tested in clinical trials for patients with very low-risk and low-volume early-stage prostate cancer and has been demonstrated to be safe and effective in those individuals, but it has not yet been used in combination with another treatment such as radiotherapy, nor has it used to treat more aggressive or advanced prostate cancer.

Dr Bryant said: “Radiotherapy can cure many cases of prostate cancer, but it can cause difficult side effects and it may not be able to successfully treat some patients – possibly because the cancer has already spread or because some patients have a particularly aggressive form of the disease.

“We know that radiotherapy can still be improved and this is where I hope that this project takes us. We want to see if we can combine radiotherapy with another novel treatment. If we can show that this is safe and achievable then it could lead to a reduction in the necessary radiotherapy dose currently given to men with prostate cancer, thereby reducing the side effects of treatment.”

He added: “It is highly exciting research and I feel that this could be a potential game-changer for radiotherapy treatment for men with prostate cancer. My hope is that it could lead to a step-change in the delivery of modern radiotherapy with the addition of a minimally invasive form of targeted surgery, and my aim would be to have early-phase clinical trials in patients within five years.”

Dr Karen Noble, head of research training and fellowships at Cancer Research UK, said: “These awards allow us to support talented clinicians who will become the next generation of leaders in cancer research. They help encourage clinicians to continue to carry out vital research in conjunction with their clinical work treating patients

“This exciting piece of work which the Clinical Careers Committee has chosen to fund will discover if a new approach to the treatment of prostate cancer works well – and most importantly is safe – in patients.”

Anti-malaria drug could make tumours easier to treat

An anti-malaria drug could help radiotherapy destroy tumours according to a Cancer Research UK-funded study published in Nature Communications.

The study, carried out at the CRUK/MRC Oxford Institute for Radiation Oncology in Oxford, looked at the effect of the drug, called atovaquone, on tumours with low oxygen levels in mice to see if it could be repurposed to treat cancer.

Radiotherapy works by damaging the DNA in cells. A good supply of oxygen reduces the ability of cancer cells to repair broken DNA. So when a tumour has low levels of oxygen, it can repair itself more easily after radiotherapy.

This means that tumours with low oxygen levels are more difficult to treat successfully with radiotherapy. They are also more likely to spread to other parts of the body.

This research showed for the first time that an anti-malaria drug slows down the rate at which cancer cells use oxygen by targeting the mitochondria, the powerhouses of the cell that make energy, a process that uses oxygen.

By slowing down the use of oxygen, this drug reverses the low-oxygen levels in nearly all of the tumours. The fully-oxygenated tumours are more easily destroyed by radiotherapy.

The drug was shown to be effective in a wide range of cancers, including lung, bowel, brain, and head and neck cancer. This older medicine is no longer patented and is readily and cheaply available from generic medicines manufacturers.

Professor Gillies McKenna, Cancer Research UK Oxford Centre Director and joint lead author alongside Dr Geoff Higgins, said: “This is an exciting result. We have now started a clinical trial in Oxford to see if we can show the same results in cancer patients. We hope that this existing low cost drug will mean that resistant tumours can be re-sensitised to radiotherapy. And we’re using a drug that we already know is safe.”

Dr Emma Smith, Cancer Research UK’s science information manager, said: “The types of cancer that tend to have oxygen deprived regions are often more difficult to treat – such as lung, bowel, brain and head and neck cancer. Looking at the cancer-fighting properties of existing medicines is a very important area of research where medical charities can make a big impact and is a priority for Cancer Research UK. Clinical trials will tell us whether this drug could help improve treatment options for patients with these types of tumour.”